30 Surgical therapy in the N0 neck with oral cavity CASOHNDMinimal morbidityReduces the risk of occult diseaseAvoid the undesirable side effect of RT ( RT is reserved for possible future tx. of second primary tumor )

31 RT in the N0 neck with oral cavity CAAn alternative treatment to SOHNDPORT of the surgically treated primary tumor site, the neck has not been dissected, and the risk of occult regional dz. is substantialPrimary tumor is treated with RT and the risk of occult node > 20%

32 Elective neck dissection VS Elective neck irradiationENI reduced neck failure rate in pt with control primary tumor and N0 neck from 18% to 1.9%In T1N0 SCCA oral tongue, ENI provided 95% control rate for neck recurrences compare with 38% without ENIModality is chosen to Tx primary cancer may also help in formulating a decision as to how to tx the neck